妊娠早期甲状腺功能指标参考区间的初步调查

目的探讨妊娠早期甲状腺功能指标分布特征,比较妊娠早期与非妊娠育龄期妇女的甲状腺功能水平,初步调查妊娠早期甲状腺功能指标参考区间。方法选择2011年8月-2012年2月就诊于北京同仁医院的355例正常妊娠早期妇女（妊娠早期组）及非妊娠期妇女402例（对照组）。描述两组人群甲状腺功能指标游离三碘甲状腺原氨酸（free triiodothyronine,FT3）、游离甲状腺素（free thyroxine,FT4）、促甲状腺素（thyroid-stimulating hor-mone,TSH）、三碘甲状腺原氨酸（triiodothyronine,TT3）、甲状腺素（thyroxine,TT4）、甲状腺过氧化物酶抗体（thyroidperoxidase antibody,TPOAb）和甲状腺球蛋白抗体（thyroglobulin antibody,TGAb）]的分布特征并进行比较,建立妊娠早期妇女甲状腺功能指标参考区间。结果妊娠早期组血清FT3、FT4、TSH、和TPOAb水平均明显低于对照组,妊娠早期组TT3、TT4和TGAb水平均明显高于对照组（均P〈0.05）。妊娠早期妇女FT3、FT4、TSH、TT3、TT4、TPOAb、TGAb参考区间分别为3.51-5.63 pmol/L,7.89-13.30 pmol/L,0.45-2.95 mIU/L,1.51-2.61 nmol/L,80.65-137.00 nmol/L,0.10-4.81 IU/mL,9.40-59.30 IU/mL。结论妊娠早期妇女甲状腺功能指标相比对照组妇女有明显差异,建立中国人群妊娠早期妇女甲状腺功能指标的参考区间有重要临床意义。

An initial investigation of serum thyroid function markers reference intervals in early gestation of pregnant women

Objective To explore the distribution characteristics of the maternal thyroid function markers in the early gestation of pregnant women, compare these markers with control group, and establish the reference intervals in the early gestation of pregnant women. Methods 355 pregnancies of early gestation （early gestation of pregnant women group） and 402 cases of non-pregnant women （control group） were selected from August 2011 to February 2012 in Beijing Tongren Hospital. The distribution characteristics of thyroid function indicators serum free triiodothyronine （FT3）, free thyroxine （FT4）, thyroid-stimulating hormone （TSH）, triiodothyronine （TT3）, thyroxine （TT4）, thyroid peroxidase antibody （TPOAb） and thyroglobnlin antibody （TGAb）] were described and compared in the two groups. Then maternal thyroid function indicators reference interval for early gestation of pregnant women were established. Results In the early gestation of pregnant women group, maternal serum FT3, FT4, TSH, and TPOAb were significantly lower than those in the control group; TT3, rF＇F4 and TGAb were significantly higher than those in the control group （all P 〈 0.05）. In early gestation of pregnancy women, the reference intervals of FT3, FT4, TSH, TY3, TT4, TPOAb and TGAb were 3.51-5.63 pmol/L, 7.89-13.30 pmol/L 0.45-2.95 mU/L, 1.51-2.61 nmol/L, 80.65-137.00 nmol/L, 0.10-4.81 U/mL, 9.40-59.30 U/mL respectively. Conclusion There are differences in serum thyroid hormones levels between early gestation of pregnant women and control group women. Therefore, it is importance to establish reference intervals of serum thyroid hormones in early gestation of pregnant women.